Provider Demographics
NPI:1811358716
Name:PIVOT WORKS
Entity type:Organization
Organization Name:PIVOT WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-797-0919
Mailing Address - Street 1:BP 23
Mailing Address - Street 2:CHEZ PIVOT
Mailing Address - City:RANOMAFANA
Mailing Address - State:IFANADIANA
Mailing Address - Zip Code:312
Mailing Address - Country:MG
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BP 23
Practice Address - Street 2:CHEZ PIVOT
Practice Address - City:RANOMAFANA
Practice Address - State:IFANADIANA
Practice Address - Zip Code:312
Practice Address - Country:MG
Practice Address - Phone:01126133-899-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD61488251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare